Revenue Cycle Analyst

CVS Health

2d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Revenue Cycle Analyst reports directly to the Senior Manager, Reimbursements Concepts, Inc (RCI). This is a client-facing position, wherein you will support external clients. This person will play an integral role in delivering cost-effective solutions for our external clients through reporting, analytics, and database management, delivering on client expectations for RCI’s services. This person is responsible for completing all internal RCI reporting requirements, as well as external client reporting needs, to ensure client and departmental financial expectations are met or exceeded. Conducts data analysis and performs financial reviews to identify opportunities for revenue cycle improvement, including areas such as coding, billing, and reimbursement. Coordinates with cross-functional teams, including finance, billing, and coding departments, to identify and resolve revenue cycle issues, ensuring accurate and timely reimbursement. Under close supervision monitors key performance indicators (KPIs) and metrics related to revenue cycle management, providing regular reports and insights to management for decision-making and performance evaluation. Assists in the development and implementation of revenue cycle improvement initiatives, such as process enhancements, technology solutions, and training programs. Conducts audits and reviews to ensure compliance with coding, billing, and reimbursement regulations, identifying areas of non-compliance and implementing corrective actions. Coordinates with revenue cycle stakeholders to optimize revenue capture, streamline workflows, and improve operational efficiency. Performs revenue cycle month end close processes and reporting; Meets and or exceeds our clients' month end reporting expectation of 3-5 business days post close. To be successful in this role, this person will utilize home infusion software, Microsoft Excel, payer portals, and other systems, as well as their critical thinking skills, to ensure a high quality of performance. This person will also need analytical skills and verbal and written communication skills, in order to effectively communicate with internal staff and external client personnel via telephone and email.

Requirements

• 3+ years of experience in revenue cycle management operations.
• 3+ years of experience in healthcare.
• Working knowledge of Medicare, Medicaid and Third-Party Insurance payers and reimbursement guidelines.
• Strong competency with Microsoft Office software applications (Outlook, Word, Excel).

Nice To Haves

• Excellent attention to detail, as well as the ability to handle stress and meet deadlines.
• Strong organizational skills, as well as the ability to manage multiple assignments and meet deadlines
• Knowledge of Home Infusion, DME (Durable Medical Equipment) and/or Specialty Pharmacy billing.
• Excellent customer service skills.
• Experience with medical billing and/or collections, or experience with accounts receivable (AR) and/or healthcare reimbursement systems.
• Analytical experience, including root cause analysis.
• Bachelor’s degree in Business or related field.

Responsibilities

• Support external clients.
• Deliver cost-effective solutions for our external clients through reporting, analytics, and database management, delivering on client expectations for RCI’s services.
• Complete all internal RCI reporting requirements, as well as external client reporting needs, to ensure client and departmental financial expectations are met or exceeded.
• Conducts data analysis and performs financial reviews to identify opportunities for revenue cycle improvement, including areas such as coding, billing, and reimbursement.
• Coordinates with cross-functional teams, including finance, billing, and coding departments, to identify and resolve revenue cycle issues, ensuring accurate and timely reimbursement.
• Under close supervision monitors key performance indicators (KPIs) and metrics related to revenue cycle management, providing regular reports and insights to management for decision-making and performance evaluation.
• Assists in the development and implementation of revenue cycle improvement initiatives, such as process enhancements, technology solutions, and training programs.
• Conducts audits and reviews to ensure compliance with coding, billing, and reimbursement regulations, identifying areas of non-compliance and implementing corrective actions.
• Coordinates with revenue cycle stakeholders to optimize revenue capture, streamline workflows, and improve operational efficiency.
• Performs revenue cycle month end close processes and reporting
• Meets and or exceeds our clients' month end reporting expectation of 3-5 business days post close.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED